Ventilating means for surgical casts



June 3, 1958 E. Q. MOSES VENTILATING MEANS FOR SURGICAL CASTS II I United States Patent 2,837,088 VENTILATING MEANS FOR SURGICAL CASTS Edmund Quincy Moses, Scarborough, N. Y.

Application March 11, 1955, Serial No. 493,794

3 Claims. (Cl. 128-91) This invention is an improvement on the invention disclosed in my application, Serial No. 274,339, filed March 1, 1952, Patent No. 2,704,067.

An important drawback to the use of surgical casts as at present widely employed is that ready access of air to the surfaces of the body covered by the cast is prevented. This results in discomfort and may be the cause of temporary or permanent injury to the skin and tissues. This invention relates to improved means by which a cast may be ventilated so as to overcome the objection-noted.

In accordance with the present invention a preformed ventilating element is provided which may be introduced by the surgeon into the cast as it is applied whereby ventilating openings may be formed in the cast at any desired point. The ventilating means comprises inserts which are incorporated into the cast at the time the plaster of Paris bandages, or other settable cast forming means are applied. These inserts have large flat areas overlying the body surfaces so. as to prevent pressure points at localized areas, and in preferred forms the body facing surfaces are covered with pads of felt or other soft resilient material.

Another feature of the invention includes the covering of the body facing surfaces with an adhesive by which they may be adhered directly to the body surface or preferably to the lining of stockinet or the like with which the skin is usually covered before the plaster of Paris or other settable bandages are applied. Desirably these inserts have tacky adhesive coated faces and are furnished with pieces of gauze covering the adhesive which may be readily stripped off by the surgeon or nurse at the time the insert is to be used, and the inserts instantly placed and temporarily secured in those locations which the surgeon deems most advantageous from the point of view of the ventilating effect and also of avoiding pressure on the bones or portions of the body where such pressure would be most noticeable.

Another feature which may be incorporated in the invention when desired is the use of an insert having a plurality of ventilating openings and formed as a long strip which may be mounted along the line of the cast which it is deemed will be most advantageous for cutting or sawing when the cast is to be removed. A portion of the insert is made thick enough to form a protection against the cutting of the flesh by the saw or tool used for splitting the cast. The line of ventilating holes, which are visible from the outside of the cast surface, serves as a guide by which the position of the protective base strip may be determined when applying the saw.

In the accompanying drawings forming a part of this application,

Figure 1 is a perspective view showing an insert member formed of plastic or other suitable material such as thin metal, ceramic material, or even wood, this member having a resilient layer thereon.

Figure 2 is a side elevation partly in longitudinal sec- 2,837,088 Patented June 3, 1958 tion of a modified form of the insert or ventilating member.

Figure 3 is a plan view of the member shown in Fig. 2.

Figure 4 is a perspective view of a part of the body having a cast thereon, parts being broken away to show the ventilating insert.

Figure 5 is a fragmentary transverse sectional view on line 5-5 of Fig. 4 showing how a saw may be used to split the cast.

' Referring to the drawings in detail the insert or ventilator shown in Fig. 1 comprises a large flat head 10 from which protrudes a hollow stem 12 having a pointed end 14. The hole through the stem stops short of the point at the outside, but is open at the inside, that is, the side nearest to the body member to which the cast is to be applied. Permanently attached to the inside of the head 10 is a cushioning layer 16 of felt, sponge rubber or the like, the inner surface of which is shown as coated with a permanently tacky adhesive coating 18. When the article is supplied from the factory, the coating is preferably covered by a layer of gauze 20 which is'stripped off when the article is to be used. The tacky adhesive then adheres to the stockinet or other cast lining so that the ventilator may be immediately applied and retained in any desired position while the settable bandage is wrapped. After the cast has set the pointedend of the stem is cut off, a ventilating hole being thereby formed completely through the stem from the inside of the cast to the outside thereof. The head 10 is preferably made of substantial diameter so as to distribute pressure over a considerable surface of the body. It may be curved or otherwise shaped to fit the part and is preferably made of a relatively flexible plastic so that it may yield slightly to conform to the body surface. The stem 12, however, should be cured or otherwise formed in such a way as to be hard enough to retain a point which will penetrate the wet bandage while it is being applied. This permits the surgeon to have the utmost freedom in applying the bandage without interference from the ventilator. -In the use of devices of this kind it may be desirable also for the surgeon to draw the ventilator stem outwardly slightly as by applying a pair of pliers thereto after the bandage is wrapped, but before the plaster has set, so as to insure that there will be a minimum of pressure of the base of the ventilator upon the skin. If desired the stem may be provided with a rib or thread 22 to facilitate gripping it for drawing it outward.

In Figs. 2 and 3 a large insert is shown having a plurality of ventilating tubes thereon. In this instance the insert is shown as formed as in integral plastic molding, the base consisting of a reticulated structure comprising crossed ribs 22', the hollow stems 12 being molded integrally therewith. The plastic base may be so formed as to have a substantial degree of flexibility. The inside of the base is preferably provided with pad 16 of felt or the like, which may be coated with adhesive 18 and covered by a temporary gauze layer 20. In some'instances it may be desirable to have the edge portions 24 of the pad project out beyond the edges of the base so as to prevent any possibility of such base edges applying localized pressure to the skin. The plaster on the bandage may enter the openings between the ribs 22 thereby forming an interlock with the base. Also, the openwork base is more flexible.

Figs. 4 and 5 show a ventilating insert in the form of a long strip 30 preferably formed of a hard surfaced plastic, but which, because of its elongated shape, will have a certain amount of flexibility permitting it to conform to the body contours. This strip has a thickened portion 32 running along its center from which protrude a plurality of hollow ventilating stems 12 located in a longitudinal line. The side portions of the strip may be thinned out so as to be slightly flexible in a lateral direction. The inner surface of the strip maybe covered with felt or other padding and coated with adhesive or not as desired.

When the cast ha'sset and the protruding ends of the stems have been cut off, the series of ventilating holes will bevisible. These holes serve as a guide when it comes time to remove the cast as the surgeon can follow the line of holes with his saw. The thickened portion 32 of the ventilating insert acts as a'protectien against injury to the skin by the saw. Preferably the'outer surface of the base is smooth, so that the part of the cast at the side of the saw cut will free inself from the strip thereby permitting spreading and removal of the cast. If desired the outer surface of the base may be coated with a substance such as a silicone compound which will prevent adherence of the plaster. The strip 30 may be made of metal if desired, or if of plastic, it may have metal reinforcing strips 34 therein.

While certain preferred embodiments of the invention have been illustrated and described in detail, it is to be understood that changes may be made therein and the invention embodied in other structures. It is not, therefore, the intention to limit the patent to the specific construction illustrated, but the appended claims are intended to cover the invention broadly in whatever form its principles may be utilized.

What I claim is:

1. Ventilating means for incorporating into surgical casts, comprising a base having a hollow ventilating stem of small bore projecting therefrom substantially per- '4 pendicularly to the base, the inner surface of the base having a layer of padding aflixed thereto coated on its exposed surface with a tacky adhesive, said padding having a passage therethrough communicating with the bore of the hollow stem.

2. A ventilating and protective insert for surgical casts comprising an elongated strip having a central portion extending lengthwise thereof serving as a protection when splitting the cast for removal, the insert having a longitudinal series of hollow ventilating nipples serving not only for ventilating purposes, but also to guide the surgeon in applying the saw for splitting the cast in such a location that the base of the insert protects the skin from the saw the base of the insert having a saw resisting material incorporated therein and extending lengthwise thereof.

3. A ventilating and protective insert as claimed in claim 2 in which the strip and nipples are of plastic, the central portion of the strip being thicker than the side edges, the saw resisting material comprising a strip of metal.

References Cited in the file of this patent UNITED STATES PATENTS 1,984,158 Scholl Dec 11, 1934 2,480,849 Gersh et a1. Sept. 6, 1949 2,704,067 Moses Mar. 15, 1955 2,731,963 Blank Jan. 24, 1956 FOREIGN PATENTS 463,068 Great Britain Mar. 22, 1937 

